Root Canal Treatment and Endodontics

Root Canal Treatment is a common  dental treatment to save a tooth which is badly decayed. The root canal treatment has a false reputation of being painful. Rather, it is a quick, comfortable procedure to relieve your tooth pain and save your natural tooth. A root canal treatment (also know as endodontic treatment) is a serious procedure effectively done a specialist. It is better to know the facts of a root canal, before engaging into getting one.

If you have been prescribed a ‘Root Canal Treatment’, there is nothing to be worried about. Each year, millions of teeth are treated using this procedure to save the natural tooth, relieving pain and making teeth healthy again. Read on to know more about Root Canal Treatment.

Root Canal is not a treatment, but simply a part of the tooth root, which is hollow and contains the nerve tissue, blood vessels, and cells, collectively known as the pulp. The tooth is formed of crown and roots. The crown is above the gum, while the roots are below the gum. The roots hold the tooth to the jawbone.

The pulp inside the crown and the root of  the tooth nourishes and provides moisture to the surroundings and underlying tissues. It is the nerves within the pulp that sense hot and cold temperatures which translate as pain.

Root canal therapy is a solution for restoring and preserving a severely injured or contaminated tooth instead of removing the teeth.

Root canal therapy is performed in stages and takes anywhere from one to three sessions.

• The first stage is having the area ready

The dentist must clean the contaminated pulp and fill the canals, for which the dentist would numb the area first. The numbing fluid (Anaesthesia) is injected into the gums and the base of the tooth. The dentist puts a dental dam in the mouth after the area has been numbed. The majority of the teeth in the mouth are covered, isolating the tooth which requires a root canal. With the patient under local anesthesia, the dentist makes a small hole on the top of the tooth to access the pulp. Later the diseased and dead pulp is removed using small files

• The second stage is to fill substance

Next, the dentist cleans, decontaminates and shapes the hollow area, with irrigation solutions. The tooth is then filled with a rubber-like substance ‘gutta-percha’ and the canals are completely sealed with adhesive cement. Once the Root canal therapy is done, pulp is completely removed along with the infection. In effect, after root canal therapy, the tooth is dead. The patient will no longer feel any pain or discomfort in that tooth because the pulp has been removed, and the infection has been eliminated.

• The Third stage is to place a customised crown that matches existing teeth

After the second stage, the tooth will be more fragile than before. A tooth with no pulp must receive its nourishment from the ligament that attaches the tooth to the bone. This supply is adequate, but in time, the tooth will become more brittle, so a crown or filling offers protection. Therefore, in the third and last stage, endodontist will advise a crown as it protects, stabilizes and re-infirces the treated tooth by covering it. The permanent crown is made to look like natural teeth. Once in place, patients can chew hard foods and no longer feel pain

Root canal treatment costs vary widely, but saving your natural tooth with a root canal is relatively cost efficient. The other option is extraction of tooth, and the cost of bridging the gap with a dental implant or bridge is more expensive. Also, tooth extraction can lead to malocclusion, or misaligned teeth, and difficulty chewing.

As with any procedure or treatment, complications can occur.  Common complications are perforation of tooth/canal, re-infection, instrument separation/breakage, over filling of canal, discoloration of tooth, Sinus drainage. Sometimes the dentist only finds three root canals in a tooth that has four. If one canal remains untreated, the infection might continue and spread into the bone.

If complications occur, a specialist can try to correct the problem and complete the root canal. It is imperative for the patient to always follow the dentists’ instructions, to avoid complications. If an antibiotic is needed or prescribed, it is important to finish the entire prescription. Also, it is essential to have a permanent restoration placed, such as a crown, once the root canal therapy is complete.

Normally, complications in Root Canal Treatment are easily treated by an Endodontist.

If you’ve had root canal therapy, you may have been referred to an Endodontist. Endodontics is the dental specialty that deals with the pulp and nerves of the tooth. This specialty also focuses on the diagnosis, prevention and treatment of diseases related to the pulp. Endodontic care involves either preserving part, or all of the healthy dental pulp in health, or removing all of the pulp in irreversible disease. This includes teeth with irreversibly inflamed and infected pulpal tissue. Endodontic treatment is one of the most common procedures. If the dental pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue), becomes diseased or injured, endodontic treatment is required to save the tooth.

Endodontists are skilled dental specialists in diagnosing and treating pulpal diseases and performing root canal treatment and other procedures to relieve pain. Highly trained endodontists (dental specialists) repair tissues inside the tooth in intricate ways. They diagnose and treat complex causes of tooth pain.

• Root canal treatment
• Apicoectomy
• Microsurgical endodontics

Also called root end surgery, is an endodontic surgical procedure whereby a tooth’s root tip is removed and a root end cavity is prepared and filled with a biocompatible material. An apicoectomy is necessary when conventional root canal therapy has failed and a re-treatment was already unsuccessful or is not advised.

The treatment is normally done manually or under a microscope as microsurgery. To access the root, an endodontist needs to perform a surgical incision to separate the gum and to lift it away from the tooth. The dentist uses a special dye to check whether any fractures or cracks are found in the tooth. If present, It is necessary to extract the tooth rather than performing an apicoectomy.

During the apicoectomy procedure, Infected tissue and as well tip of the root is removed. The dentist cleans the root canal and then sealed it between 3 and 4 mm in length. To get a clear picture of the region, the endodontist uses a surgical microscope and other tools. An apicoectomy can take anywhere from 30 minutes to 90 minutes, depending on the area affected. The endodontist uses an x-ray to ensure that the region has been fully sealed until it is closed off.

An endodontist will guide you on how to care for the affected area and what you should eat. You may experience some side effects like swelling and bruising after a day of the procedure. This can be treated with over-the-counter painkillers. Try to stick to soft foods and avoid brushing in the treated area. Dentists will remove the stitches between two to seven days and advise you when to return.

This state-of-the-art procedure makes use of microsurgical techniques, such as a dental operating microscope, micro-instruments, ultrasonic preparation tips, and calcium silicate-based filling materials. It is performed under microsurgery to save a tooth. The endodontist will first inject local anesthesia and then open a gum tissue, followed by removing the damaged tissue. At the end of the root, a small filling is placed and then a few stitches are placed to heal the tissue. Over time, the bone heals and patients can resume their daily activities the next day. You may experience some discomfort, after the post-surgery. If you have severe pain, please call your dentist as soon as possible.

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